NPIMap

Organization Active NPI

Change Inc

Doing business as FMC SBHC

  • Physician Assistant
  • Weirton, WV
National Provider Identifier
1912311705
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
CHANGE INC
Doing business as
FMC SBHC
Practice address
3248 Pennsylvania Ave
Weirton, WV 26062-3804
Phone
(304) 748-2828
NPI assigned
Jun 19, 2014
Last updated
Jun 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Judy Raveaux
Title
Ceo
Phone
(304) 797-7733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

3248 Pennsylvania Ave
Weirton, WV 26062-3804

Mailing address

3248 Pennsylvania Ave
Weirton, WV 26062-3804
Phone (304) 748-2828

Other names 1

  • FMC SBHC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Change Incorporated8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1912311705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 PENNSYLVANIA AVE",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623804",
            "telephone_number": "304-748-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 PENNSYLVANIA AVE",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623804",
            "telephone_number": "304-748-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "RAVEAUX",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-797-7733"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMC SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weirton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.